My mother used to say, “If I put $1 away every time (blank) happened, I could have retired by now.” Today, we could fill in the blank with, “the Centers for Medicare and Medicaid Services (CMS) touches the Plan Finder and there are new problems.”
Since its introduction in August 2019, I have written a dozen posts about this important tool. CMS continues its efforts to enhance the user experience but, in many cases, those enhancements are simply changes in appearance, such as a different font or reorganization of the information. And, with just about every “enhancement,” the Plan Finder seems to take a step or two backward. For example, a May 2021 post noticed problems with default reporting of drug costs.
A cleaner-looking page buries valuable data
Late last month, CMS debuted its most recent changes: a major reorganization of drug plan information on the plan details page.
- Plan phone numbers and a link to a plan‘s website are at the top of the page, a helpful change.
- This is followed by a chart, comparing yearly drug costs by pharmacy, estimated total drug plus premium cost, and estimated monthly drug costs, sort of a more elaborate plan comparison page.
- Finally, links for star ratings are at the bottom.
That’s it, one page that appears far less intimidating. However, the new design is not really conducive to learning about the plan.
When first writing content for our website years ago, my web designer son-in-law told me that everything important should be on one page. If a user has to click a link, it probably won’t be seen. This most recent redesign buries the following important information (that previously appeared automatically) behind links labeled “View more drug coverage.”
- Costs in drug payment stages (retail cost, cost before and after deductible, and in the coverage gap) by pharmacy
- Cost by drug tier (preferred generic, generic, preferred and non-preferred brand, and specialty) for preferred and standard retail pharmacy and mail order
- The tier of medications
- The drug list, and
- Coverage rules (prior authorization, step therapy, quantity limits).
The first time I used the Plan Finder after this update, I missed the last link. I couldn’t believe CMS eliminated the tiers and coverage rules. Only then did I discover the links. I fear many beneficiaries won’t and, if they do, will they actually click on them?
The ever-changing “Drugs covered/Not covered”
Now, here is what got broken during this enhancement.
The plan comparison page notes prescription drugs that are covered. “6 of 6 drugs covered” means the plan covers all medications. “4 of 6 drugs covered” means the plan does not cover two.
Why is this important? If the plan does not cover all drugs, the beneficiary will have to pay the full cost for noncovered drugs. In some cases, this could add thousands of dollars to the cost of drugs. When I see that a plan does not cover all drugs, I eliminate that from the comparison.
Selecting a plan for a client after this last update, I chose three plans that cover her four drugs and would be cost-effective. She asked that I check the plan her husband has so I removed one plan from the comparison and added in that new one. Suddenly, the comparison page then noted that all plans (two in the first comparison and the new one) covered 3 of 4 drugs. Thinking maybe I hadn’t seen that the first time around, I clicked on plan details to confirm the first two plans did cover all drugs. Each time I returned to the plan comparison page, the “Drugs covered/Not covered” notation changed.
Two plans cover 3 of 4, the middle plan covers 4 of 4.
The first plan covers 3 of 4 and the other two 3 of 4.
All 3 plans cover 4 of 4 drugs.
Without any inside knowledge, my son-in-law says this may be related to a tracking variable that isn’t updating properly, whatever that means.
Digging into these anomalies, these numbers start changing when adding to the comparison a plan that does not cover every drug. Removing that plan fixes the results.
Pay attention and you’ll notice one other interesting event. In these same spots, as the information loads, you’ll see this in red type for just a split second, “There was an error retrieving drug information.” Really?
Open Enrollment is coming
There are three recurring themes in this CMS update.
- Covered and noncovered drugs were displaying correctly before but then the page redesign broke this. Similar things have happened with previous updates.
- It appears no one on the CMS team found this problem before release of the update, and that’s unfortunate. I shared these findings with a fellow drug plan reviewer who was very relieved to learn that she wasn’t the only one experiencing these issues.
- This Plan Finder, even though “prettier,” still is not working as smoothly as the legacy version, its predecessor. With Open Enrollment starting in less than two months, that is a real concern.